WO2007118978A1 - Total or partial trapezium bone replacement implant and method of manufacturing this implant - Google Patents
Total or partial trapezium bone replacement implant and method of manufacturing this implant Download PDFInfo
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- WO2007118978A1 WO2007118978A1 PCT/FR2007/000548 FR2007000548W WO2007118978A1 WO 2007118978 A1 WO2007118978 A1 WO 2007118978A1 FR 2007000548 W FR2007000548 W FR 2007000548W WO 2007118978 A1 WO2007118978 A1 WO 2007118978A1
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- base cylinder
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4261—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for wrists
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30108—Shapes
- A61F2002/30199—Three-dimensional shapes
- A61F2002/30291—Three-dimensional shapes spirally-coiled, i.e. having a 2D spiral cross-section
- A61F2002/30293—Cylindrical body made by spirally rolling up a sheet or a strip around itself
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30462—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements retained or tied with a rope, string, thread, wire or cable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
- A61F2/4261—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for wrists
- A61F2002/4271—Carpal bones
- A61F2002/4274—Distal carpal row, i.e. bones adjacent the metacarpal bones
- A61F2002/4276—Trapezium
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0075—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0091—Three-dimensional shapes helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section
Definitions
- the present invention relates to an implant for total or partial replacement of a trapezium bone.
- French Patent Application No. 2 801 194 discloses an implant for total or partial replacement of a cuboidal bone, in particular trapezium, comprising a core of nonabsorbable rigid material, and a casing made of a non-resorbable fibrous material, with a structure porous.
- This implant has a form of revolution, rounded side wall and convex and truncated longitudinal ends, giving it the shape of a "small barrel”.
- this implant makes it possible to perfectly restore the anatomical movement of the thumb and, thanks to its porous envelope, can be perfectly integrated with the surrounding tissues by growth of the cells in the pores of said envelope.
- the implant according to this prior document although giving overall satisfaction, however, has the important disadvantage of suffering wear in its areas cooperating with the joint surfaces of the bones concerned. Indeed, these articular surfaces are generally resected and therefore have relatively aggressive edges, which wear and / or notch the envelope of the implant. In addition to a defective operation of the joint, it results in a diffusion in the surrounding tissues of particles of the material forming said envelope, which generates an inflammation of these tissues and therefore joint pain.
- the present invention aims to remedy this essential disadvantage.
- the operation of the known implant can be improved.
- EP 1 290 993, US 5 514 180, WO 01/70139 and EP 0 966 930 disclose vertebral implants unrelated to an implant for replacing a trapezium bone.
- the implant that the invention relates to comprises:
- the shape of the inserts is independent of that of the body and can be adapted to that of the articular surfaces.
- the insert intended to cooperate with the first metacarpal may have a convex articular surface and the insert intended to cooperate with the scaphoid may have a concave articular surface.
- the body advantageously has a porous structure in order to allow the implant to be held in position by growth of cells in the pores of this body.
- the implant may also include at least one suture connected to it, allowing its attachment to the surrounding tissue implantation site.
- the body also advantageously has a slightly deformable structure, allowing its curvature and / or its axial compression.
- the implant may comprise guide means allowing guided mobility of one insert relative to the other.
- each of the inserts comprises a boss forming a hinge surface, one of the articulation surfaces being concave, in particular partially hemispherical, and the other surface being convex, these surfaces of articulation coming, when the implant is formed, in contact with one another. A multidirectional articulation of one insert relative to the other is thus obtained.
- the body of the implant may in particular be constituted by a strip of porous material wound in a spiral so as to form a cylinder, the inserts being placed at the two axial ends of this cylinder.
- This porous material is preferably polyester, especially polyester terephthalate.
- the body of the implant may in particular be constituted by a band of porous material wound in a spiral so as to form a cylinder comprising an axial cavity;
- each insert comprises a boss pierced with a transverse hole intended to be engaged in this axial cavity
- each insert is fixed to the body by means of sutures passing through at least once an area of the body wall, said transverse hole and an opposite zone of the body wall.
- the method according to the invention comprises the steps of:
- Said sutures are thus perfectly protected against friction that may exert bones or surrounding tissues on the implant during joint movements.
- Figure 1 is a perspective view of three elements it comprises, according to a first embodiment
- Figure 2 is a sectional view, after assembly
- Figures 3 to 8 are sectional views in six successive steps of its manufacture
- Figure 9 is a view after implantation
- Figure 10 is a view similar to Figure 9, on an enlarged scale
- Figure 11 is a perspective view of the three elements of the implant, according to the second embodiment
- Figures 12 and 13 are side views of the implant, respectively in undeformed and deformed form
- Figures 14 and 15 are views respectively similar to Figures 12 and 13, in cross-section of the implant. .
- Figures 9 and 10 show an implant 1 total or partial replacement of the trapezoid bone, that is to say an implant intended to allow, after ablation of the trapezium, to restore the possibility of articulated movement of the first metacarpal 101 compared to the scaphoid 102.
- the implant 1 comprises a body 2 and two inserts 3. It may also comprise one or more suture threads 4, connected to needles, for its attachment to the surrounding tissues its implantation zone. these wires 4 being engaged through the wall of the body 2.
- the latter is constituted by a knitted and / or woven polyester terephthalate web, which is wound in a spiral so as to form an axial cavity cylinder, the inserts 3 being put in place at the two axial ends of this cylinder.
- the inserts 3 are made of a metallic material, in particular stainless steel. Each of them has a circular portion 5, defining an articular surface 6, 7 on one side, and comprises a boss 8 projecting from the face of this circular portion 5 opposite to those defining said articular surface 6, 7.
- the insert 3 intended to cooperate with the first metacarpal 101 has a convex articular surface 6 and the insert 3 intended to cooperate with the scaphoid 102 has a concave articular surface 7.
- Each boss 8 is dimensioned such that it can be engaged in the axial cavity of the body 2, and is pierced with a transverse hole 9.
- FIG. 3 to 8 illustrate different successive steps of manufacture of the implant 1.
- the polyester terephthalate strip is first partially wound so as to form a base cylinder delimiting said axial cavity, and the bosses 8 of the two inserts 3 are engaged in this cavity, as shown in FIG. 3.
- a first suture thread 10 is then put in place as shown in FIG. 4, crossing twice a zone of the wall of the base cylinder, the transverse hole 9 of a first insert 3, and an opposite zone of the wall of the base cylinder, then crossing an area of the wall of the base cylinder, the transverse hole of the boss 9 of the second insert 3, and an opposite zone of the wall of the base cylinder.
- the ends of the wire 10 are then knotted (FIG. 5) and then fused, this wire 10 being made of a hot-melt material, in particular polyester (see FIG. 6).
- a second suture 11 is then placed in the same manner, along an inverted path with respect to that shown in FIG. 4, that is to say starting from the face of the base cylinder situated on the right. of this figure ( Figure 7).
- polyester terephthalate web is then wrapped around the base roll, thus covering the threads 10, 11 and their sutures, until integrally forming the body 2 of the implant 1, as shown in FIG. 8, and the end of this band is fixed to the rest of the body 2 by a suture.
- the implant 1 is placed in the space left free by ablation of the trapezium, and, where appropriate, is attached to the surrounding tissue by means of the son 4, so that the articular surfaces 6, 7 of the inserts 3 are facing the respective articular bone surfaces of the first metacarpal 101 and the scaphoid 102.
- the articular bone surfaces therefore bear against the inserts 3 during articular movements, which resist perfectly, given their constituent material, the friction and pressure that these surfaces exert on them. Any problem of wear of the implant and diffusion of particles to the surrounding tissues is thus eliminated.
- the articular surfaces 6, 7, respectively convex and concave, of the inserts 3 are adapted to the respective shapes of the articular surfaces of the first metacarpal 101 and the scaphoid 102.
- the porous structure of the body 2 enables the implant 1 to be held in position by growth of cells in the pores of this body 2, and the latter is also slightly deformable to enable the implant 1 to be adapted to the stresses transmitted by the 101, 102, in particular a slight compression of the implant 1 in the direction of the approximation / removal of the inserts 3 from each other.
- FIGS. 11 to 15 show an implant 1 of the same structure, that is to say comprising a body 2 and two inserts 3 with bosses 8 and holes 9.
- the boss 8 of one of the inserts 3 forms a concave articulation surface 15 and the boss 8 of the other insert 3 form a convex hinge surface, these surfaces being partially hemispherical.
- these articulating surfaces 15, 16 come, when the implant 1 is formed, in contact with one another, thus forming a multidirectional articulation which allows the guided mobility of a insert 3 with respect to the other.
- the implant 1 can thus be deformed as shown in FIGS. 13 and 15, that is to say with curvature of the body 2.
- the invention thus provides a total or partial replacement implant of a trapezium bone, which overcomes significant disadvantages of existing implants of the same indication.
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
According to the invention, this implant (1) includes a body (2) and two inserts (3) made of a material resisting repeated friction against bone joint surfaces, particularly made of a metal material, the two inserts (3) being fixed to the body (2) so as to be facing said bone joint surfaces when the implant (1) is put into position.
Description
IMPLANT DE REMPLACEMENT TOTAL OU PARTIEL D'UN OS DU TRAPEZE ET PROCEDE DE FABRICATION DE CET IMPLANT TOTAL OR PARTIAL REPLACEMENT IMPLANT OF A TRAPEZE BONE AND METHOD OF MANUFACTURING THE IMPLANT
La présente invention concerne un implant de remplacement total ou partiel d'un os du trapèze.The present invention relates to an implant for total or partial replacement of a trapezium bone.
La demande de brevet français N° 2 801 194 décrit un implant de remplacement total ou partiel d'un os cuboïforme, en particulier du trapèze, comprenant un noyau en matériau rigide non résorbable, et une enveloppe en un matériau fibreux non résorbable, à structure poreuse. Cet implant présente une forme de révolution, à paroi latérale arrondie et convexe et à extrémités longitudinales tronquées, lui conférant la forme d'un "petit tonneau".French Patent Application No. 2 801 194 discloses an implant for total or partial replacement of a cuboidal bone, in particular trapezium, comprising a core of nonabsorbable rigid material, and a casing made of a non-resorbable fibrous material, with a structure porous. This implant has a form of revolution, rounded side wall and convex and truncated longitudinal ends, giving it the shape of a "small barrel".
Par sa courbure dans deux plans perpendiculaires, cet implant permet de parfaitement restituer le mouvement anatomique du pouce et, grâce à son de enveloppe poreuse, peut être parfaitement intégré aux tissus environnants par croissance des cellules dans les pores de ladite enveloppe.By its curvature in two perpendicular planes, this implant makes it possible to perfectly restore the anatomical movement of the thumb and, thanks to its porous envelope, can be perfectly integrated with the surrounding tissues by growth of the cells in the pores of said envelope.
L'implant selon ce document antérieur, bien que donnant globalement satisfaction, a cependant pour inconvénient important de subir une usure au niveau de ses zones coopérant avec les surfaces articulaires des os concernés. En effet, ces surfaces articulaires sont généralement réséquées et présentent par conséquent des arêtes relativement agressives, qui usent et/ou entaillent l'enveloppe de l'implant. Outre un fonctionnement défectueux de l'articulation, il en résulte une diffusion dans les tissus environnants de particules du matériau formant ladite enveloppe, laquelle génère une inflammation de ces tissus et donc des douleurs articulaires.The implant according to this prior document, although giving overall satisfaction, however, has the important disadvantage of suffering wear in its areas cooperating with the joint surfaces of the bones concerned. Indeed, these articular surfaces are generally resected and therefore have relatively aggressive edges, which wear and / or notch the envelope of the implant. In addition to a defective operation of the joint, it results in a diffusion in the surrounding tissues of particles of the material forming said envelope, which generates an inflammation of these tissues and therefore joint pain.
La présente invention vise à remédier à cet inconvénient essentiel.The present invention aims to remedy this essential disadvantage.
Par ailleurs, d'une manière générale, le fonctionnement de l'implant connu apparaît pouvoir être amélioré.Moreover, in general, the operation of the known implant can be improved.
Les documents EP 1 290 993, US 5 514 180, WO 01/70139 et EP 0 966 930 décrivent des implants vertébraux, sans rapport avec un implant de remplacement d'un os du trapèze.EP 1 290 993, US 5 514 180, WO 01/70139 and EP 0 966 930 disclose vertebral implants unrelated to an implant for replacing a trapezium bone.
L'implant que l'invention concerne comprend :The implant that the invention relates to comprises:
- un corps, et- a body, and
- deux inserts en matériau résistant à une friction répétée contre des surfaces osseuses articulaires, notamment en un matériau métallique, les deux inserts étant fixés au corps de manière à se trouver en regard desdites surfaces osseuses articulaires lorsque l'implant est mis en place.
Les surfaces osseuses articulaires portent donc contre ces inserts lors des mouvements articulaires, qui résistent parfaitement, compte tenu de leur matériau constitutif, aux frottements et pressions que ces surfaces exercent sur eux. Le problème précité d'usure de l'implant et de diffusion de particules dans les tissus environnants est ainsi éliminé.two inserts made of material that is resistant to repeated friction against articular bone surfaces, in particular made of a metallic material, the two inserts being fixed to the body so as to face said articular bone surfaces when the implant is put in place. The articular bone surfaces therefore bear against these inserts during articular movements, which resist perfectly, given their constituent material, the friction and pressure that these surfaces exert on them. The aforementioned problem of implant wear and scattering of particles in the surrounding tissues is thus eliminated.
De plus, la forme des inserts est indépendante de celle du corps et peut être adaptée à celle des surfaces articulaires. Ainsi, l'insert destiné à coopérer avec le premier métacarpien peut présenter une surface articulaire convexe et l'insert destiné à coopérer avec le scaphoïde peut présenter une surface articulaire concave.In addition, the shape of the inserts is independent of that of the body and can be adapted to that of the articular surfaces. Thus, the insert intended to cooperate with the first metacarpal may have a convex articular surface and the insert intended to cooperate with the scaphoid may have a concave articular surface.
Le corps présente avantageusement une structure poreuse afin de permettre le maintien en position de l'implant par croissance de cellules dans les pores de ce corps. L'implant peut également comprendre au moins un fil de suture relié à lui, permettant sa fixation aux tissus environnants son site d'implantation.The body advantageously has a porous structure in order to allow the implant to be held in position by growth of cells in the pores of this body. The implant may also include at least one suture connected to it, allowing its attachment to the surrounding tissue implantation site.
Le corps présente en outre avantageusement une structure légèrement déformable, permettant sa courbure et/ou sa compression axiale.The body also advantageously has a slightly deformable structure, allowing its curvature and / or its axial compression.
Cette légère déformabilité permet une adaptation de l'implant aux contraintes transmises par les os entre lesquels cet implant est mis en place.This slight deformability allows an adaptation of the implant to the stresses transmitted by the bones between which this implant is put in place.
L'implant peut comprendre des moyens de guidage permettant une mobilité guidée d'un insert par rapport à l'autre. Selon une forme de réalisation préférée dans ce cas, chacun des inserts comprend un bossage formant une surface d'articulation, l'une des surfaces d'articulation étant concave, notamment partiellement hémisphérique, et l'autre surface étant convexe, ces surfaces d'articulation venant, lorsque l'implant est constitué, au contact l'une de l'autre. Une articulation multidirectionnelle d'un insert par rapport à l'autre est ainsi obtenue.The implant may comprise guide means allowing guided mobility of one insert relative to the other. According to a preferred embodiment in this case, each of the inserts comprises a boss forming a hinge surface, one of the articulation surfaces being concave, in particular partially hemispherical, and the other surface being convex, these surfaces of articulation coming, when the implant is formed, in contact with one another. A multidirectional articulation of one insert relative to the other is thus obtained.
Le corps de l'implant peut notamment être constitué par une bande de matériau poreux enroulée en spirale de manière à former un cylindre, les inserts étant mis en place au niveau des deux extrémités axiales de ce cylindre. Ce matériau poreux est de préférence du polyester, notamment du polyester téréphtalate.The body of the implant may in particular be constituted by a strip of porous material wound in a spiral so as to form a cylinder, the inserts being placed at the two axial ends of this cylinder. This porous material is preferably polyester, especially polyester terephthalate.
Selon une forme de réalisation possible de l'invention,
- le corps de l'implant peut notamment être constitué par une bande de matériau poreux enroulée en spirale de manière à former un cylindre comprenant une cavité axiale ;According to one possible embodiment of the invention, the body of the implant may in particular be constituted by a band of porous material wound in a spiral so as to form a cylinder comprising an axial cavity;
- chaque insert comprend un bossage percé d'un trou transversal, destiné à être engagé dans cette cavité axiale, eteach insert comprises a boss pierced with a transverse hole intended to be engaged in this axial cavity, and
- chaque insert est fixé au corps au moyen de sutures traversant au moins une fois une zone de la paroi du corps, ledit trou transversal et une zone opposée de la paroi du corps.each insert is fixed to the body by means of sutures passing through at least once an area of the body wall, said transverse hole and an opposite zone of the body wall.
Pour la réalisation de l'insert ci-dessus, le procédé selon invention comprend les étapes consistant à :For carrying out the above insert, the method according to the invention comprises the steps of:
- enrouler partiellement la bande de matériau poreux de manière à former un cylindre de base ;partially winding the strip of porous material so as to form a base cylinder;
- engager les bossages des deux inserts dans les extrémités de la cavité axiale que forme ce cylindre de base ;engaging the bosses of the two inserts in the ends of the axial cavity formed by this base cylinder;
- réaliser au moins une suture traversant au moins une fois une zone de la paroi du cylindre de base, le trou transversal du bossage d'un premier insert, et une zone opposée de la paroi du cylindre de base, puis traversant une zone de la paroi du cylindre de base, le trou transversal du bossage du deuxième insert, et une zone opposée de la paroi du cylindre de base ;performing at least one suture traversing at least once a zone of the wall of the base cylinder, the transverse hole of the boss of a first insert, and an opposite zone of the wall of the base cylinder, then passing through an area of the wall of the base cylinder, the transverse hole of the boss of the second insert, and an opposite zone of the wall of the base cylinder;
- enrouler le reste de la bande de matériau poreux autour du cylindre de base, recouvrant ainsi lesdites sutures, jusqu'à constituer intégralement le corps de l'implant.- Wrap the rest of the porous material web around the base cylinder, thus covering said sutures, until integrally constituting the body of the implant.
Lesdites sutures sont ainsi parfaitement protégées à l'égard des frottements que peuvent exercer les os ou tissus environnants sur l'implant lors des mouvements articulaires.Said sutures are thus perfectly protected against friction that may exert bones or surrounding tissues on the implant during joint movements.
L'invention sera bien comprise, et d'autres caractéristiques et avantages de celle-ci apparaîtront, en référence au dessin schématique annexé, représentant, à titre d'exemples non limitatifs, deux formes de réalisation possibles de l'implant qu'elle concerne.The invention will be better understood, and other features and advantages thereof will become apparent, with reference to the appended diagrammatic drawing, showing, by way of non-limiting examples, two possible embodiments of the implant that it concerns. .
La figure 1 est une vue en perspective de trois éléments qu'il comprend, selon une première forme de réalisation ; la figure 2 en est une vue en coupe, après assemblage ; les figures 3 à 8 en sont des vues en coupe au cours de six étapes successives de sa fabrication ; la figure 9 en est une vue après implantation ;
la figure 10 en est une vue similaire à la figure 9, à échelle agrandie ; la figure 11 est une vue en perspective des trois éléments de l'implant, selon la deuxième forme de réalisation ; les figures 12 et 13 sont des vues de l'implant de côté, selon respectivement une forme non déformée et une forme déformée, et les figures 14 et 15 sont des vues respectivement similaires aux figures 12 et 13, en coupe transversale de l'implant.Figure 1 is a perspective view of three elements it comprises, according to a first embodiment; Figure 2 is a sectional view, after assembly; Figures 3 to 8 are sectional views in six successive steps of its manufacture; Figure 9 is a view after implantation; Figure 10 is a view similar to Figure 9, on an enlarged scale; Figure 11 is a perspective view of the three elements of the implant, according to the second embodiment; Figures 12 and 13 are side views of the implant, respectively in undeformed and deformed form, and Figures 14 and 15 are views respectively similar to Figures 12 and 13, in cross-section of the implant. .
Par simplification, les éléments ou parties d'éléments qui se retrouvent d'une forme de réalisation à l'autre seront identifiés par les mêmes références numériques et ne seront pas à nouveau décrits.For simplicity, elements or parts of elements that are found from one embodiment to another will be identified by the same reference numerals and will not be described again.
Les figures 9 et 10 représentent un implant 1 de remplacement total ou partiel de l'os du trapèze, c'est-à-dire un implant destiné à permettre, après ablation du trapèze, de restituer la possibilité de mouvement articulé du premier métacarpien 101 par rapport au scaphoïde 102.Figures 9 and 10 show an implant 1 total or partial replacement of the trapezoid bone, that is to say an implant intended to allow, after ablation of the trapezium, to restore the possibility of articulated movement of the first metacarpal 101 compared to the scaphoid 102.
Comme le montrent les figures 1 et 2, l'implant 1 comprend un corps 2 et deux inserts 3. Il peut également comprendre un ou plusieurs fils de suture 4, reliés à des aiguilles, pour sa fixation aux tissus environnants sa zone d'implantation, ces fils 4 étant engagés au travers de la paroi du corps 2.As shown in FIGS. 1 and 2, the implant 1 comprises a body 2 and two inserts 3. It may also comprise one or more suture threads 4, connected to needles, for its attachment to the surrounding tissues its implantation zone. these wires 4 being engaged through the wall of the body 2.
Ce dernier est constitué par une bande de polyester téréphtalate tricoté et/ou tissé, qui est enroulée en spirale de manière à former un cylindre à cavité axiale, les inserts 3 étant mis en place au niveau des deux extrémités axiales de ce cylindre.The latter is constituted by a knitted and / or woven polyester terephthalate web, which is wound in a spiral so as to form an axial cavity cylinder, the inserts 3 being put in place at the two axial ends of this cylinder.
Les inserts 3 sont en un matériau métallique, notamment en acier inoxydable. Chacun d'eux présente une partie circulaire 5, définissant une surface articulaire 6, 7 sur une face, et comprend un bossage 8 faisant saillie de la face de cette partie circulaire 5 opposée à celles définissant ladite surface articulaire 6, 7.The inserts 3 are made of a metallic material, in particular stainless steel. Each of them has a circular portion 5, defining an articular surface 6, 7 on one side, and comprises a boss 8 projecting from the face of this circular portion 5 opposite to those defining said articular surface 6, 7.
L'insert 3 destiné à coopérer avec le premier métacarpien 101 présente une surface articulaire 6 convexe et l'insert 3 destiné à coopérer avec le scaphoïde 102 présente une surface articulaire 7 concave.The insert 3 intended to cooperate with the first metacarpal 101 has a convex articular surface 6 and the insert 3 intended to cooperate with the scaphoid 102 has a concave articular surface 7.
Chaque bossage 8 est dimensionné de telle sorte qu'il peut être engagé dans la cavité axiale du corps 2, et est percé d'un trou transversal 9.Each boss 8 is dimensioned such that it can be engaged in the axial cavity of the body 2, and is pierced with a transverse hole 9.
Les figures 3 à 8 illustrent différentes les étapes successives de fabrication de l'implant 1. La bande de polyester téréphtalate est tout d'abord enroulée partiellement de manière à former un cylindre de base délimitant
ladite cavité axiale, et les bossages 8 des deux inserts 3 sont engagés dans cette cavité, ainsi que le montre la figure 3. Un premier fil de suture 10 est ensuite mis en place comme indiqué sur la figure 4, en traversant à deux reprises une zone de la paroi du cylindre de base, le trou transversal 9 d'un premier insert 3, et une zone opposée de la paroi du cylindre de base, puis en traversant une zone de la paroi du cylindre de base, le trou transversal du bossage 9 du deuxième insert 3, et une zone opposée de la paroi du cylindre de base. Les extrémités du fil 10 sont ensuite nouées (figure 5) puis fusionnées, ce fil 10 étant en un matériau thermofusible, notamment en polyester (cf. figure 6).Figures 3 to 8 illustrate different successive steps of manufacture of the implant 1. The polyester terephthalate strip is first partially wound so as to form a base cylinder delimiting said axial cavity, and the bosses 8 of the two inserts 3 are engaged in this cavity, as shown in FIG. 3. A first suture thread 10 is then put in place as shown in FIG. 4, crossing twice a zone of the wall of the base cylinder, the transverse hole 9 of a first insert 3, and an opposite zone of the wall of the base cylinder, then crossing an area of the wall of the base cylinder, the transverse hole of the boss 9 of the second insert 3, and an opposite zone of the wall of the base cylinder. The ends of the wire 10 are then knotted (FIG. 5) and then fused, this wire 10 being made of a hot-melt material, in particular polyester (see FIG. 6).
Un deuxième fil de suture 11 est alors mis en place de la même manière, selon un parcours inversé par rapport à celui montré sur la figure 4, c'est-à- dire a partir de la face du cylindre de base située sur la droite de cette figure (figure 7).A second suture 11 is then placed in the same manner, along an inverted path with respect to that shown in FIG. 4, that is to say starting from the face of the base cylinder situated on the right. of this figure (Figure 7).
Le reste de la bande de polyester téréphtalate est alors enroulé autour du cylindre de base, recouvrant ainsi les fils 10, 11 et leurs sutures, jusqu'à constituer intégralement le corps 2 de l'implant 1, comme le montre la figure 8, et l'extrémité de cette bande est fixée au reste du corps 2 par une suture.The remainder of the polyester terephthalate web is then wrapped around the base roll, thus covering the threads 10, 11 and their sutures, until integrally forming the body 2 of the implant 1, as shown in FIG. 8, and the end of this band is fixed to the rest of the body 2 by a suture.
L'implant 1 est mis en place dans l'espace laissé libre par l'ablation du trapèze, et, le cas échéant, est fixé aux tissus environnants au moyen des fils 4, de telle sorte que les surfaces articulaires 6, 7 des inserts 3 soient tournées vers les surfaces osseuses articulaires respectives du premier métacarpien 101 et du scaphoïde 102.The implant 1 is placed in the space left free by ablation of the trapezium, and, where appropriate, is attached to the surrounding tissue by means of the son 4, so that the articular surfaces 6, 7 of the inserts 3 are facing the respective articular bone surfaces of the first metacarpal 101 and the scaphoid 102.
Les surfaces osseuses articulaires portent donc contre les inserts 3 lors des mouvements articulaires, qui résistent parfaitement, compte tenu de leur matériau constitutif, aux frottements et pressions que ces surfaces exercent sur eux. Tout problème d'usure de l'implant et de diffusion de particules vers les tissus environnants est ainsi éliminé.The articular bone surfaces therefore bear against the inserts 3 during articular movements, which resist perfectly, given their constituent material, the friction and pressure that these surfaces exert on them. Any problem of wear of the implant and diffusion of particles to the surrounding tissues is thus eliminated.
Les surfaces articulaires 6, 7, respectivement convexe et concave, des inserts 3 sont adaptées aux formes respectives des surfaces articulaires du premier métacarpien 101 et du scaphoïde 102.The articular surfaces 6, 7, respectively convex and concave, of the inserts 3 are adapted to the respective shapes of the articular surfaces of the first metacarpal 101 and the scaphoid 102.
La structure poreuse du corps 2 permet le maintien en position de l'implant 1 par croissance de cellules dans les pores de ce corps 2, et ce dernier est en outre légèrement déformable pour permettre une adaptation de l'implant 1 aux contraintes transmises par les os 101 , 102, en particulier une
légère compression de l'implant 1 dans la direction du rapprochement/éloignement des inserts 3 l'un de l'autre.The porous structure of the body 2 enables the implant 1 to be held in position by growth of cells in the pores of this body 2, and the latter is also slightly deformable to enable the implant 1 to be adapted to the stresses transmitted by the 101, 102, in particular a slight compression of the implant 1 in the direction of the approximation / removal of the inserts 3 from each other.
Les figures 11 à 15 représentent un implant 1 de même structure, c'est- à-dire comprenant un corps 2 et deux inserts 3 à bossages 8 et trous 9. Dans ce cas, le bossage 8 de l'un des inserts 3 forme une surface d'articulation concave 15 et le bossage 8 de l'autre insert 3 forme une surface d'articulation convexe, ces surfaces étant partiellement hémisphériques.FIGS. 11 to 15 show an implant 1 of the same structure, that is to say comprising a body 2 and two inserts 3 with bosses 8 and holes 9. In this case, the boss 8 of one of the inserts 3 forms a concave articulation surface 15 and the boss 8 of the other insert 3 form a convex hinge surface, these surfaces being partially hemispherical.
Comme le montrent les figures 12 à 15, ces surfaces d'articulation 15, 16 viennent, lorsque l'implant 1 est constitué, au contact l'une de l'autre, formant ainsi une articulation multidirectionnelle qui permet la mobilité guidée d'un insert 3 par rapport à l'autre. L'implant 1 peut ainsi se déformer comme montré sur les figures 13 et 15, c'est-à-dire avec courbure du corps 2.As shown in FIGS. 12 to 15, these articulating surfaces 15, 16 come, when the implant 1 is formed, in contact with one another, thus forming a multidirectional articulation which allows the guided mobility of a insert 3 with respect to the other. The implant 1 can thus be deformed as shown in FIGS. 13 and 15, that is to say with curvature of the body 2.
L'invention fournit ainsi un implant de remplacement total ou partiel d'un os du trapèze, qui remédie à des inconvénients importants des implants existants de même indication.The invention thus provides a total or partial replacement implant of a trapezium bone, which overcomes significant disadvantages of existing implants of the same indication.
Il va de soi que l'invention n'est pas limitée à la forme de réalisation décrite ci-dessus à titre d'exemple mais qu'elle s'étend à toutes les formes de réalisations couvertes par les revendications ci-annexées.
It goes without saying that the invention is not limited to the embodiment described above by way of example but that it extends to all embodiments covered by the appended claims.
Claims
REVENDICATIONS
1 - Implant (1) de remplacement total ou partiel d'un os du trapèze, caractérisé en ce qu'il comprend :1 - Implant (1) for total or partial replacement of a trapezius bone, characterized in that it comprises:
- un corps (2), eta body (2), and
- deux inserts (3) en matériau résistant à une friction répétée contre des surfaces osseuses articulaires, notamment en un matériau métallique, les deux inserts (3) étant fixés au corps (2) de manière à ce que, lorsque l'implant (1) est mis en place, l'un des inserts (3) soit situé en regard de la surface articulaire du premier métacarpien (101), et l'autre insert (3) soit situé en regard de la surface articulaire du scaphoïde (102).two inserts (3) of material that is resistant to repeated friction against articular bone surfaces, in particular of a metallic material, the two inserts (3) being fixed to the body (2) so that, when the implant (1) ) is put in place, one of the inserts (3) is located opposite the articular surface of the first metacarpal (101), and the other insert (3) is located opposite the articular surface of the scaphoid (102) .
2 - Implant (1) selon la revendication 1 , caractérisé en ce que l'insert (3) destiné à coopérer avec le premier métacarpien (101) présente une surface articulaire (6) convexe et en ce que l'insert (3) destiné à coopérer avec le scaphoïde (102) présente une surface articulaire (7) concave.2 - Implant (1) according to claim 1, characterized in that the insert (3) intended to cooperate with the first metacarpal (101) has a convex articular surface (6) and in that the insert (3) intended to cooperate with the scaphoid (102) has a concave articular surface (7).
3 - Implant (1) selon la revendication 1 ou la revendication 2, caractérisé en ce que le corps (2) présente une structure poreuse.3 - Implant (1) according to claim 1 or claim 2, characterized in that the body (2) has a porous structure.
4 - Implant (1) selon l'une des revendications 1 à 3, caractérisé en ce qu'il comprend au moins un fil de suture (4) relié à lui, permettant sa fixation aux tissus environnants son site d'implantation.4 - Implant (1) according to one of claims 1 to 3, characterized in that it comprises at least one suture (4) connected to it, allowing its attachment to the surrounding tissue implantation site.
5 - Implant (1) selon l'une des revendications 1 à 4, caractérisé en ce que le corps (2) présente une structure légèrement déformable, permettant sa courbure et/ou sa compression axiale.5 - Implant (1) according to one of claims 1 to 4, characterized in that the body (2) has a slightly deformable structure, allowing its curvature and / or its axial compression.
6 - Implant (1) selon la revendication 5, caractérisé en ce qu'il comprend des moyens de guidage permettant une mobilité guidée d'un insert (3) par rapport à l'autre.6 - Implant (1) according to claim 5, characterized in that it comprises guide means for guided mobility of an insert (3) relative to the other.
7 - Implant (1) selon la revendication 6, caractérisé en ce que chacun des inserts (3) comprend un bossage (8) formant une surface d'articulation (15, 16), l'une des surfaces d'articulation (15) étant concave, notamment partiellement hémisphérique, et l'autre surface (16) étant convexe, ces surfaces d'articulation (15, 16) venant, lorsque l'implant (1) est constitué, au contact l'une de l'autre.7 - Implant (1) according to claim 6, characterized in that each of the inserts (3) comprises a boss (8) forming a hinge surface (15, 16), one of the articulation surfaces (15) being concave, in particular partially hemispherical, and the other surface (16) being convex, these articulation surfaces (15, 16) coming, when the implant (1) is formed, in contact with one another.
8 - Implant (1) selon l'une des revendications 1 à 7, caractérisé en ce que le corps (2) de l'implant (1) est constitué par une bande de matériau poreux enroulée en spirale de manière à former un cylindre, les inserts (3) étant mis en place au niveau des deux extrémités axiales de ce cylindre.
9 - Implant (1) selon l'une des revendications 1 à 8, caractérisé en ce que :8 - Implant (1) according to one of claims 1 to 7, characterized in that the body (2) of the implant (1) is constituted by a strip of porous material wound in a spiral so as to form a cylinder, the inserts (3) being placed at the two axial ends of this cylinder. 9 - Implant (1) according to one of claims 1 to 8, characterized in that:
- le corps (2) est constitué par une bande de matériau poreux enroulée en spirale de manière à former un cylindre comprenant une cavité axiale ;the body (2) consists of a porous material strip wound in a spiral so as to form a cylinder comprising an axial cavity;
- chaque insert (3) comprend un bossage (8) percé d'un trou transversal (9), destiné à être engagé dans cette cavité axiale, eteach insert (3) comprises a boss (8) pierced with a transverse hole (9) intended to be engaged in this axial cavity, and
- chaque insert (3) est fixé au corps (2) au moyen de sutures (10, 11) traversant au moins une fois une zone de la paroi du corps (2), ledit trou transversal (9) et une zone opposée de la paroi du corps (2).each insert (3) is fixed to the body (2) by means of sutures (10, 11) traversing at least once a zone of the wall of the body (2), said transverse hole (9) and an opposite zone of the body wall (2).
10 - Procédé de fabrication d'un implant (1) selon la revendication 9, caractérisé en ce qu'il comprend les étapes consistant à :10 - Method for manufacturing an implant (1) according to claim 9, characterized in that it comprises the steps of:
- enrouler partiellement la bande de matériau poreux de manière à former un cylindre de base ;partially winding the strip of porous material so as to form a base cylinder;
- engager les bossages (8) des deux inserts (3) dans les extrémités de la cavité axiale que forme ce cylindre de base ;- engage the bosses (8) of the two inserts (3) in the ends of the axial cavity formed by the base cylinder;
- réaliser au moins une suture (10, 11) traversant au moins une fois une zone de la paroi du cylindre de base, le trou transversal (9) du bossage (8) d'un premier insert (3), et une zone opposée de la paroi du cylindre de base, puis traversant une zone de la paroi du cylindre de base, le trou transversal (9) du bossage (8) du deuxième insert (3), et une zone opposée de la paroi du cylindre de base ;- Making at least one suture (10, 11) traversing at least once an area of the wall of the base cylinder, the transverse hole (9) of the boss (8) of a first insert (3), and an opposite zone from the wall of the base cylinder, then through an area of the wall of the base cylinder, the transverse hole (9) of the boss (8) of the second insert (3), and an opposite zone of the wall of the base cylinder;
- enrouler le reste de la bande de matériau poreux autour du cylindre de base, recouvrant ainsi lesdites sutures (10, 11), jusqu'à constituer intégralement le corps (2) de l'implant (1).
- Wrap the rest of the band of porous material around the base cylinder, thus covering said sutures (10, 11), until integrally the body (2) of the implant (1).
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR0602800 | 2006-03-31 | ||
FR0602800A FR2899095B1 (en) | 2006-03-31 | 2006-03-31 | TOTAL OR PARTIAL REPLACEMENT IMPLANT OF CUBOIFORM BONE AND METHOD OF MANUFACTURING THE SAME |
Publications (1)
Publication Number | Publication Date |
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WO2007118978A1 true WO2007118978A1 (en) | 2007-10-25 |
Family
ID=37441347
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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PCT/FR2007/000548 WO2007118978A1 (en) | 2006-03-31 | 2007-03-30 | Total or partial trapezium bone replacement implant and method of manufacturing this implant |
Country Status (2)
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FR (1) | FR2899095B1 (en) |
WO (1) | WO2007118978A1 (en) |
Families Citing this family (3)
Publication number | Priority date | Publication date | Assignee | Title |
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FR2928831B1 (en) * | 2008-03-19 | 2011-04-29 | Xavier Renard | PROTHETIC IMPLANT FOR SUSPENSOPLASTY AFTER A TRAPEZECTOMY AND METHOD FOR REALIZING SUCH IMPLANT |
FR2931059B1 (en) * | 2008-05-16 | 2011-10-07 | Memometal Technologies | PROSTHESIS OF JOINT BETWEEN TWO BONES, IN PARTICULAR PROTHESIS TRAPEZO-METACARPIENNE |
FR2956805B1 (en) * | 2010-03-01 | 2012-11-02 | Xavier Renard | PROTHETIC IMPLANT FOR REPLACING SMALL BONE DIMENSIONS |
Citations (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0526682A1 (en) * | 1991-08-07 | 1993-02-10 | Oscobal Ag | Endoprosthesis with a metal wire mesh |
US5514180A (en) * | 1994-01-14 | 1996-05-07 | Heggeness; Michael H. | Prosthetic intervertebral devices |
WO1998047449A1 (en) * | 1997-04-18 | 1998-10-29 | W.L. Gore & Associates, Inc. | Resorbable interposition arthroplasty implant |
EP0966930A1 (en) * | 1998-06-23 | 1999-12-29 | Biomet Merck Limited | Vertebral body replacement |
FR2801194A1 (en) * | 1999-11-19 | 2001-05-25 | Fixano | An implant for restoring articulated movement to the thumb comprises a rigid barrel shaped core of polyethylene and a fibrous polyester envelope, both non resorbable, and attachment sutures. |
WO2001070139A2 (en) * | 2000-03-22 | 2001-09-27 | Synthes (U.S.A) | Skeletal reconstruction cages |
EP1290993A1 (en) * | 2001-09-10 | 2003-03-12 | Aesculap AG & Co. KG | Implant |
US20040247641A1 (en) * | 2002-01-22 | 2004-12-09 | Felt Jeffrey C. | Interpositional arthroplasty system & method |
-
2006
- 2006-03-31 FR FR0602800A patent/FR2899095B1/en not_active Expired - Fee Related
-
2007
- 2007-03-30 WO PCT/FR2007/000548 patent/WO2007118978A1/en active Application Filing
Patent Citations (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0526682A1 (en) * | 1991-08-07 | 1993-02-10 | Oscobal Ag | Endoprosthesis with a metal wire mesh |
US5514180A (en) * | 1994-01-14 | 1996-05-07 | Heggeness; Michael H. | Prosthetic intervertebral devices |
WO1998047449A1 (en) * | 1997-04-18 | 1998-10-29 | W.L. Gore & Associates, Inc. | Resorbable interposition arthroplasty implant |
EP0966930A1 (en) * | 1998-06-23 | 1999-12-29 | Biomet Merck Limited | Vertebral body replacement |
FR2801194A1 (en) * | 1999-11-19 | 2001-05-25 | Fixano | An implant for restoring articulated movement to the thumb comprises a rigid barrel shaped core of polyethylene and a fibrous polyester envelope, both non resorbable, and attachment sutures. |
WO2001070139A2 (en) * | 2000-03-22 | 2001-09-27 | Synthes (U.S.A) | Skeletal reconstruction cages |
EP1290993A1 (en) * | 2001-09-10 | 2003-03-12 | Aesculap AG & Co. KG | Implant |
US20040247641A1 (en) * | 2002-01-22 | 2004-12-09 | Felt Jeffrey C. | Interpositional arthroplasty system & method |
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FR2899095A1 (en) | 2007-10-05 |
FR2899095B1 (en) | 2009-01-30 |
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